| NPI | 1528302064 |
|---|---|
| Former Name | CRYSTAL ANN SHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ME MD22907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125062499) |
| 208000000X Pediatrics (Licence: IL 125062499) | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2019-05-02 |